So I work in a rural hospital in the mid-atlantic. My profession is anesthesia, and I’m newly passionate about keto. I was doing a procedure in a patient’s (pts) room yesterday who happened to be, like most of my pts, T2DM. Just striking up a conversation I asked him how his sugars were that morning. He said in the am, pre-breakfast, it was 135. Between breakfast and lunch it was 277. I said, “Oh. What did you have for breakfast?” He said, “Well, they got me on the diabetic diet so I had french toast, rice krispies, cranberry juice, and milk.” Trying not to look shocked I said, “So you had a lot of sugar for breakfast?” He says, “No I didn’t. There wasn’t sugar in the french toast or rice krispies.” Hmmmm… So the purpose of this thread is to talk about changing the health care environment in which you work. I’m confident the physicians who approve this hospital diet are unaware of it’s danger. And I know for a fact that the nutritionist here, with whom I’ve spoken about keto before, thinks the amount of fat in this diet is dangerous and that the diet is only reserved for epileptics. I am debating whether or not I should have a conversation with the chief of medicine regarding the keto diet and start by saying, “So when was the last time you cured a diabetic?” and just see where that leads. I’m also debating whether to make a formal presentation of the research and science behind keto and presenting it to whoever wants to listen among the hospital staff. What are your thoughts? I am having some success with co-workers though. Two of them that are diabetics are now on keto (well, one is starting this weekend). But I just feel this info is way too important to keep from my patients and the professionals that care for them. Any advice?
Questions for Health Care Professionals
I am in a similar boat. I have been an ICU Rn for many years and currently am a Nurse Educator. Everything I know as a type 2 diabetic goes against the majority of what is taught to patients and what I was taught as a type 2 diabetic. I don’t know where the starting point should be - dieticians, physicians, the diabetic educator. There are certainly a lot of arms to this beast. I do share with coworkers what I am doing and I initially got the crazy side eye, but as I am physically changing I am gaining more interest. I think personally I would starve if I was hospitalized - probably a good time for some IF!
I agree with Ruthann. Where to start. Carl and Richard suggest paying it forward and helping others. I had a luncheon for 3 diabetic friends and 1 who is grossly overweight. Served keto and a keto dessert. Showed them how to read labels and look for hidden sugars. Gave them a 30 carb limit to start with to ease them into it. A few days later one told me that she is slow and stubborn. The other said nothing but I she had a breakfast cake and said what else is she supposed to eat.? Now I have reversed my TD2 and feeling awesome. However my obese friend is making slow but steady progress in changing her diet. So the answer to your conundrum don’t know. Just trying to do my part to try to help someone else.
Change and the fight against misinformation, super hard.
I agree Renee. I also think sometimes it takes people awhile to change. I think it’s great for those who can jump in with both feet - but that isn’t everyone. I know when I first started tracking carbs as a type 2 I was well over 200g per day. I am now down to 30. It sometimes takes time and seeing the change. When you know better, you do better.
As with any revolution, the best approach is from every angle.
Everyone has their own skill set and should approach the problem from a place that makes most sense to them. You are in a position of trust have access to medical professionals, so that may be your way to contribute.
People get defensive about food and diet, so tread carefully. I find that approaching with curiosity and asking questions (in a sincere way) often gets better results than just telling someone what’s up.
Remember, you catch more flies with honey than vinegar, but it’s full of sugar, so just let the flies eat it. (there’s a better joke in there somewhere, but i leave that to someone more clever than I)
As a professional, you may be obligated to support the government guidlines. Gary Fettke, for example, a surgeon who promoted a low-carb, high-fat diet for his diabetic surgical patients, got into trouble with the Australian authorities and was censured for “inappropriately reversing” the type II diabetes of several of his patients, instead of cutting off their limbs. He has been permanently silenced and has been told that even if it should be scientifically proved that LCHF is healthier than the currently-recommended diet, he will still be forbidden to talk about LCHF with his patients. There is also a registered dietician in New Zealand who ran afoul of her professional association and has likewise been silenced. Professor Tim Noakes, a researcher in South Africa, had to defend himself from professional charges resulting from a tweet he posted about LCHF—at least he won his case, but it took a lot of effort from experts all over the world, who flew in to testify in his support.
So the moral is, tread carefully until you know where you stand professionally. If you stick with disseminating published data, you might be able to make some headway. There are researchers in the U.S. who seem to still have intact professional reputations, such as Stephen Phinney and Jeff Volek, the doctors Eades, and several of the people involved in the American Bariatric Medicine Association, which is very pro-keto (I believe Dr. Bergman is a recent past president). More power to you, if you can actually promote real change without getting into trouble!
@PaulL 's advice is well taken BUT as a non-healthcare professional I am working this out too. I have tried it a few times and am slowly refining my approach. The way I am thinking about it is as follows:
- My story (so far) - CICO failed, keto working, easiest WoE I’ve done, health benefits, weight loss etc.
- Basic Principles - WoE about health (not just weight loss), all carbs are sugar, hormonal model of metabolism, insulin is the master hormone, a calorie is NOT just a calorie, being fat/sick is a symptom/not your fault, chronic disease is largely metabolic, sugar is addictive, hunger is just sugar cravings, etc.
- Basic Approach - 20g net carbs, moderate protein, fat to satiety, lots of salt/electrolytes
- Debunking the roadblocks - saturated fat is good not bad, more salt is good (for most), CICO is BS (Biggest Loser research), cholesterol fear is BS, etc.
- How to be successful - what CAN you eat, what can’t you eat, available resources (KF, DietDoctor, ruledme, etc.)
I tailor this to the specific concern of the audience - I’ve done T2, Dementia and Cancer so far so each also has special bits relating to those.
The above list is not exhaustive BUT it is exhausting to you can pick and choose which bits are going to play best to who you are talking to. Some will want less ‘science’ and want to pitch into what they can and can’t eat but this approach gets chaotic pretty quickly, jumping from “you should eat bacon” to “saturated fat is fine… here’s the science”, back to “yes, you can have vegetables… but NOT the underground ones… nor peas or corn”, “but fruit juice is healthy…” etc. etc.
If I get around to a slideshow, I’ll release it here of course. It’s mostly been emails and conversations so far.
Thanks for all the helpful suggestions. The health care environment can be a difficult place to navigate when sharing new ideas. Workers in health care are supposed to be the experts, so it’s dofficult to convince someone that what they’ve heard and known to be “true” since the 60’s is actually wrong. But I really like the idea of winning people over with kindness, and helping them to reach the conclusion themselves, with a title guidance of course, and maybe a few RCT’s and meta analyses for their parousing. I was able to have a few conversations with pts today about keto. One woman had gotten her T2 under control with diet and exercise, but I tried to show her that some aspects of her new diet still contained foods that were counterproductive to her goals. When she told me proudly that she ate a healthy breakfast every morning consisting of oatmeal (good for cholesterol right??) she was unhappy to hear that it is a carb/sugar. Another pt had an A1c of 8 and had lost eyesight in one eye d/t diabetic retinopathy. He was very receptive to the info I gave him. I even saw a light bulb click on when he realized that this keto diet was the same one that a friend was using, and she was now off her T2 meds. I gave him some links to websites and podcasts and he seemed excited. Thanks so much for the advice!